An interdisciplinary approach to management of diastemas: A novel classification and a case report.

Diastema between the teeth negatively affects the patients' smile, psychology and daily activities by creating a disharmony in the patients' face. The development of diastema has been attributed to several factors such as labial frenulum, microdontia, mesiodens, peg-shaped lateral incisors, agenesis, cysts, habits such as finger sucking, tongue thrusting, or lip sucking, dental malformations, genetics, proclinations, dental-skeletal discrepancies, and imperfect coalescence of interdental septum. Patients often present with complex problems that require a multidisciplinary treatment approach which includes determination of the aetiological factors, soft tissue morphology, occlusion, patient demands and aesthetic consideration to achieve satisfactory outcomes. Lack of current literature on classification of diastemas and multi-disciplinary approach of management led to the proposal of a new classification the ATAC (Anatomic and Therapeutic Classification) for management of the diastema. This case report highlights the use of the proposed classification for management of diastemas, requiring a perio-restorative intervention using a Chu's proportion gauge to achieve ideal aesthetics.

Clinical efficacy of amniotic membrane with biphasic calcium phosphate in guided tissue regeneration of intrabony defects- a randomized controlled clinical trial.

BACKGROUND: The concept of periodontal regeneration has been revolutionised since the introduction of growth factors and bioactive bone substitutes which ensures optimal regeneration of the diseased periodontium. The aim of the present study was to evaluate the efficacy of Amniotic membrane + Biphasic Calcium phosphate as compared to Collagen membrane + Biphasic Calcium phosphate for the management of periodontal intrabony defects. METHODS: 50 systemically healthy patients with localised moderate to severe periodontitis, sites which had a Probing Pocket Depth (PPD) ≥ 6 mm and an intrabony component of ≥ 3 mm as detected on Intra oral periapical radiographs (IOPAR) and bone sounding were recruited based on specific inclusion and exclusion criteria. They were randomly allocated by computer generated tables to Collagen membrane + Biphasic Calcium phosphate and Amniotic membrane + Biphasic Calcium phosphate groups. The amount of bone fill and changes in Probing Pocket Depth, Clinical Attachment Level were measured at baseline and six months. RESULTS: The results of the present study showed a mean reduction in the PPD of 2.89 ± 0.69 mm in the Collagen membrane + Biphasic Calcium phosphate group and 2.95 ± 0.57 mm in the Amniotic membrane + Biphasic Calcium phosphate group and CAL gain of 2.60 ± 1.43 mm in Collagen membrane + Biphasic Calcium phosphate group 3.18 ± 1.13 mm in the Amniotic membrane + Biphasic Calcium phosphate group at 6 months follow-up with no statistical significance between the groups. In terms of Defect resolution, 98.62 ± 6.51 % was achieved in Collagen membrane + Biphasic Calcium phosphate group and 98.25 ± 7.21 % in Amniotic membrane + Biphasic Calcium phosphate group. CONCLUSIONS: Within the limitations of the present study, it can be concluded that AM can be used as a barrier membrane, in conjunction with Biphasic calcium phosphate, and provides comparable results to Collagen membrane with Biphasic calcium phosphate when used in the management of periodontal intrabony defects.

The effect of fennel seeds on pH of saliva - A clinical study.

CONTEXT: Saliva is an oral fluid that gives a protective effect against dental caries. Chewing of fennel seeds after food is a common culture in the Indian Sub-continent. A review of previous studies on fennel seeds showed that some of them have an anti-microbial efficacy, but there are no extensive data available on the effect of chewing fennel seeds on the pH of saliva. AIM: The aim of the study was to record the baseline pH of saliva and to record the changes in salivary pH after chewing fennel seeds. SETTING AND DESIGN: The study was carried out in the Department of Public Health Dentistry, Sri Ramachandra University, Chennai, prior to which a pilot study was carried out. SUBJECTS AND METHODS: Voluntary enrolment of 30 individuals was done. A written and informed consent was obtained from the individuals prior to the study. The pH of the saliva was recorded by placing the standardized salivary strip below the tongue in the oral cavity and colour changes were matched with the pH scale colour chart within about 15 sec. The subjects were asked to chew fennel seeds for 5 min. Salivary pH was measured immediately after chewing (SP2) at 0 min and the experiment was repeated for 5 min (SP3), 10 min (SP4), 15 min (SP5) and 30 min (SP6). STATISTICAL ANALYSIS: The data was gathered and analysed using paired t test. RESULTS: There was an increase in salivary pH from baseline (SP1) to 0 min (SP2) was found to be highly significant (P = 0.000). The mean salivary pH reduced to 7.64 ± 0.06, 5 min after chewing the seeds (SP3) and the drop in pH was found to be highly significant (P = 0.000). The subsequent drop in pH from 10 min (SP4), 7.50 ± 0.05 to 15 min (SP4), 7.38 ± 0.05 to 30 min (SP4), 7.24 ± 0.05 were found to be highly significant as well (P = 0.000). CONCLUSION: Chewing of fennel seeds increases the pH of saliva, thus making it a suitable anti-cariogenic agent.

Chronic periodontitis prevalence and the inflammatory burden in a sample population from South India.

CONTEXT: Periodontal diseases are among the most prevalent oral diseases in the world. Apart from repercussions in the oral cavity, there is evidence that periodontitis contributes to systemic damage in chronic diseases such as cardiovascular disease, diabetes, and preterm low birth weight. AIMS:: The aims of this study were to estimate the prevalence of chronic periodontitis in a sample urban population (<18 years) in Tamil Nadu and to estimate the inflammatory burden posed by chronic periodontitis by calculating the periodontal inflammatory surface area. SETTINGS AND DESIGN:: This was a population-based study and cross-sectional design. SUBJECTS AND METHODS:: A total of 1000 individuals (<18 years) were selected and screened for their periodontal status, oral hygiene status (OHI), and the periodontal inflamed surface area (PISA) in an outreach center located in Chennai, India. STATISTICAL ANALYSIS USED:: The proportion of individuals with different periodontal states (health, gingivitis, and periodontitis) was determined. A multivariate logistic regression analysis was performed to assess the influence of the individual risk factors such as habits (tobacco use), systemic conditions (diabetes), and oral hygiene maintenance on periodontitis prevalence in the sample population. RESULTS:: A high prevalence of periodontal disease was observed in the study population (42.3%). Among the urban participants, age, cigarette smoking, pan chewing, decayed, missing, and filled teeth scores, OHI scores, and PISA scores were found to be significantly associated with periodontitis (P < 0.05). CONCLUSIONS:: Periodontitis prevalence appears to be high even in areas with adequate access to oral health care and an inflammatory burden risk exists in a definitive manner.